Jerry Buttimer (Cork South Central, Fine Gael) | Oireachtas source

I thank the Leas-Cheann Comhairle. I appreciate the discretion.

I acknowledge that people are worried but the underlying theme is that those who deserve and require access to health care by means of a medical card will be given it.

I refer to the long-term illness scheme.

I hope the Department and the HSE will engage with Age Action Ireland, the Carers Association and other organisations to remove the fear and confusion felt by people. Our elderly, in particular, deserve to be treated with respect when they ring the helpline or engage with the HSE.

There has been a 74% increase in the number of medical and GP cards since 2005. I welcome tomorrow's appearance by HSE officials before the Committee of Public Accounts to discuss the Comptroller and Auditor General's report on medical cards. I hope they will outline where and how medical cards are being awarded. The health sector is like an underlying volcano in this State and throughout the world. For example, America is convulsed regarding Obamacare and the new health exchange websites while other countries have similar problems with this sector. This is because it is about people who require access to health care. That is why as, the Minister said earlier, the budget and service plan for 2014 will be a challenge but let us put it in context. We have experienced, thankfully, a significant increase in the number of people living longer while more people are seeking treatment, services and facilities. While staff have engaged in health service reform, it is important to recognise that we have fewer resources and staff.

It is important that the Minister and the HSE differentiate between the voices lobbying and advocating on behalf of vested interests to keep the patient at the centre. I am all in favour of the unions and medical representative organisations lobbying and advocating as part of internal medical politics but the patient must be the core of what we do. If the Minister is asked by the HSE for more time to prepare for the publication of the service plan, he should grant that because it is important that next year's plan is focused on patient safety and ensuring people are seen in a timely manner, as he said earlier. If more time is needed, the Minister should afford the HSE that opportunity to compile the service plan.

While many of us disagree about elements of what is being done, there is no disagreement that access to medical cards on the basis of medical need must always be the way. While probity is welcome and necessary, at the same time it must also be about the patient and the need to access health care. Part of the problem is the Health Act 1970 does not confer an automatic entitlement to a medical card and that is why the discretionary element must be applied in the context of medical need. The health service is undergoing reform. I applaud the staff who work in the system and it is important that health landscape continues to be patient-centred and patient-driven. We must consider the value of the medical card. John Hennessy made a good comment about the psychology of the medical card as opposed to the long-term illness scheme at the briefing earlier. We should debate the importance of the long-term illness scheme because we must communicate that to people. We have not done so at times.

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